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INTRODUCTION: Total hip arthroplasty (THA) remains one of the most successful orthopedic surgical procedures. The posterior approach is associated with a higher incidence of post-operative dislocations than others. Adequate posterior soft tissue repair techniques, including capsulorrhaphy and transosseous bone sutures in the greater trochanter effectively reduce the dislocation rate. Post-operative "posterior hip precautions" were historically believed to reduce dislocation risks, although not clearly proven. The first protocol consists of capsulorrhaphy with the prescription of post-operative posterior hip precautions (TT) and the second, transosseous bone sutures without precautions (TB). This study aims to determine the optimal protocol to decrease the dislocation rate following posterior approach primary THA. MATERIALS AND METHODS: A 10-year retrospective case-control chart review analyzed demographic, pre-, intra-, and post-surgical parameters. Primary outcomes were the difference in dislocation and revision surgery rates between protocols. Secondary outcomes included the incidence of recurrent dislocations and the identification of predictors of dislocation. RESULTS: 2,242 THAs were reviewed and 26 (1.2%) resulted in dislocation. Increased age (p = 0.04) ASA score (p = 0.03) and larger acetabular cup size (p < 0.001) were associated with heightened risk. Tendon to tendon (TT) repair saw a 1.62% dislocation rate versus 0.98% for tendon-to-bone (TB) repair, although statistically insignificant (p = 0.2). Transosseous repair resulted in recurrent dislocations for 8/16 (50%) patients compared to 6/10 (60%) in the suture group (p ≤ 0.001). No significance was found for prescription of posterior hip precautions. CONCLUSIONS: To our knowledge, this is the first study to perform a direct comparison of TT repair with posterior precautions to TB repair without posterior precautions. Similarity in dislocation rate, decreased recurrent events and the alleviated patient burden from precautions leads the authors to recommend the TB repair without precautions for a successful THA.
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Artroplastia de Reemplazo de Cadera , Luxación de la Cadera , Prótesis de Cadera , Humanos , Artroplastia de Reemplazo de Cadera/efectos adversos , Artroplastia de Reemplazo de Cadera/métodos , Luxación de la Cadera/epidemiología , Luxación de la Cadera/etiología , Luxación de la Cadera/prevención & control , Incidencia , Estudios Retrospectivos , Acetábulo/cirugía , Prótesis de Cadera/efectos adversosRESUMEN
OBJECTIVES: Road traffic injuries are a leading cause of morbidity and mortality among children in Saudi Arabia. Previous literature suggests that poor compliance to traffic safety measures is exacerbating the burden of childhood injuries. Although car seats have been found to reduce injuries among children, their compliance remains poor nationally. The aim of this study was to evaluate whether providing free car seats for newborns is associated with the compliance of car seat use 3 months after hospital discharge. METHODS: This study was conducted in three regions of the country following a national public health campaign aimed to improve traffic safety. In November 2020, five hundred car seats were given to mothers at the time of discharge. Three months later, parents were contacted to evaluate the prevalence of compliance. In addition to estimating the prevalence of car seat use at 3 months, the analysis assessed predictors of use using a multiple logistic regression model. RESULTS: Of the 486 initial participants, 375 (77%) responded. According to the parents, 76% of children still use the car seat 3 months after hospital discharge. The age of the parents and the number of family members were significant predictors of car seat use. Smaller families (≤4 members) were 2.2 (95% confidence interval: 1.36-3.82) times more likely to comply with the car seat law 3 months after discharge than larger families. Most of the respondents (70.5%) strongly agree that child restraint systems are an essential device while driving with children. CONCLUSIONS: We found that providing free car seats for newborn children is associated with uptake of improved traffic safety, but compliance remains lower than in developed countries. Further studies are needed to facilitate improving child seat safety among large families. As the country strives to invest in reducing traffic injuries, similar initiatives may facilitate adopting safety measures among parents, which may reduce preventable injuries and improve population health.
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Conducción de Automóvil , Sistemas de Retención Infantil , Accidentes de Tránsito , Humanos , Recién Nacido , Padres , Arabia SauditaRESUMEN
BACKGROUND: Recent occurrence of the 2019 coronavirus disease (COVID-19) outbreak, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has highlighted the need for fast, accurate, and simple strategies to identify cases on a large scale. OBJECTIVE: This study aims to develop and test an accurate detection and severity classification methodology that may help medical professionals and non-radiologists recognize the behavior and propagation mechanisms of the virus by viewing computed tomography (CT) images of the lungs with implicit materials. METHODS: In this study, the process of detecting the virus began with the deployment of a virtual material inside CT images of the lungs of 128 patients. Virtual material is a hypothetical material that can penetrate the healthy regions in the image by performing sequential numerical measurements to interpret images with high data accuracy. The proposed method also provides a segmented image of only the healthy parts of the lung. RESULTS: The resulting segmented images, which represent healthy parts of the lung, are classified into six levels of severity. These levels are classified according to physical symptoms. The results of the proposed methodology are compared with those of the radiologists' reports. This comparison revealed that the gold-standard reports correlated with the results of the proposed methodology with a high accuracy rate of 93%. CONCLUSION: The study results indicate the possibility of relying on the proposed methodology for discovering the effects of the SARS-CoV-2 virus in the lungs through CT imaging analysis with limited dependency on radiologists.
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COVID-19/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Algoritmos , COVID-19/patología , Diagnóstico Precoz , Humanos , Pulmón/diagnóstico por imagen , Pulmón/patología , SARS-CoV-2/aislamiento & purificación , Índice de Severidad de la EnfermedadRESUMEN
AIM: To evaluate the diagnostic performance of whole-body (WB) integrated single photon emission tomography (SPECT)/computed tomography (CT) in detecting bone metastasis (BM) and to investigate whether WB-SPECT/CT offered any additional benefit value compared to planar bone scintigraphy (PBS) with 99mTc-hydroxy-methylene diphosphonate or 99mTc methylene diphosphonate. MATERIALS AND METHODS: Medline, EMBASE, SCOPUS, Web of Science, and CINAHL were searched systematically up to 28 August 2019. All studies using histopathological analysis and/or follow-up imaging and clinical data as the reference standard were eligible for inclusion. RESULTS: Eleven studies (1,611 patients) were analysed. Based on patient analysis, the sensitivity, specificity, and area under the curve (AUC) of WB-SPECT/CT were 92% (92% confidence interval [CI], 89-95%), 95% (95% CI, 94-96%), and 0.9835, respectively, in the case of negative equivocal findings for BM, and 94% (95% CI, 91-96%), 94% (95% CI, 92-95%), and 0.9790, respectively, when regarded positive. On a lesion basis, these parameters were 91% (95% CI, 89-94%), 96% (95% CI, 94-97%), and 0.9906, respectively, in the case negative equivocal findings, and 92% (95% CI, 89-94%), 95% (95% CI, 94-97%), and 0.9898, respectively, when regarded positive. Comparing 1,265 patients from eight studies, higher sensitivity (92% versus 74%, p=0.04) and specificity for WB-SPECT/CT against PBS (93% versus 80%, p=0.01) in the case of positive equivocal findings; however, when regarded negative, WB-SPECT/CT demonstrated higher sensitivity (91% versus 70%, p=0.01), but no significant difference was apparent in specificity (94% versus 89%, p=0.07). CONCLUSION: Compared to PBS, WB-SPECT/CT had superior diagnostic accuracy in BM detection and exhibited a more reliable performance with less equivocal results.
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Neoplasias Óseas/diagnóstico por imagen , Neoplasias Óseas/secundario , Imagen Multimodal , Tomografía Computarizada de Emisión de Fotón Único , Tomografía Computarizada por Rayos X , Humanos , Radiofármacos , Medronato de Tecnecio Tc 99m , Imagen de Cuerpo EnteroRESUMEN
Gallium Phosphide (GaP) has a band gap of 2.26 eV and a valance band edge that is more negative than the water oxidation level. Hence, it may be a promising material for photoelectrochemical water splitting. However, one thing GaP has in common with other III-V semiconductors is that it corrodes in photoelectrochemical reactions. Cobalt oxide (CoOx) is a chemically stable and highly active oxygen evolution reaction co-catalyst. In this study, we protected a GaP photoanode by using a 20 nm TiO2 as a protection layer and a 2 nm cobalt oxide co-catalyst layer, which were both deposited via atomic layer deposition (ALD). A GaP photoanode that was modified by CoOx exhibited much higher photocurrent, potential, and photon-to-current efficiency than a bare GaP photoanode under AM1.5G illumination. A photoanode that was coated with both TiO2 and CoOx layers was stable for over 24 h during constant reaction in 1 M NaOH (pH 13.7) solution under one sun illumination.
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AIM: The aim of this study was to evaluate the shear bond strengths (SBSs) of one-step self-etch adhesives containing different co-solvents to enamel and dentin and to determine the failure modes of tested specimens. MATERIALS AND METHODS: Two hundred and forty (n = 240) sound human molars were used. The buccal surfaces of each tooth were ground and polished to obtain flat enamel surfaces (n = 120) or to expose the underlying dentin (n = 120). The specimens with exposed enamel or dentin were randomly divided into four main groups (n = 30) according to the one-step self-etch adhesives used: Bond-1 SF, OptiBond All-In-One, G-aenial, and Single Bond Universal adhesive. All the main groups were then subdivided into two subgroups (control and thermocycling subgroups) (n = 15). After bonding procedures, a composite restoration (Filtek Z250) was applied in a vinyl tube and condensed against the cured adhesive bonding agent, to form a resin cylinder. The specimens were stored in distilled water at 37°C for 24 hours (control and thermocycling subgroups), followed by thermocycling (5-55°C/5,000 cycles + storage in artificial saliva for 2 weeks) (thermocycling subgroup). They were subjected to SBS testing in a universal testing machine at a crosshead speed of 0.5 mm/minute. After being shear-tested, all fractured samples were examined by means of a Hirox Digital Microscope at 50× magnification for failure analysis. The data were analyzed by one-way analysis of variance followed by Tukey's post hoc analysis at a p value of ≤0.05. RESULTS: OptiBond All-In-One adhesive showed significantly higher mean SBS values on both types of tooth structures (enamel and dentin) and under different conditions (control and thermocycled) compared with the other three adhesives (p < 0.001), except in the enamel-thermocycled group, where the Single Bond Universal adhesive showed higher mean SBS but without a significant difference compared with the OptiBond All-In-One adhesive (p = 0.266), and there was no significant difference between OptiBond All-In-One and G-aenial Bond in the same group (p = 0.192). Conversely, Bond-1 SF showed significantly lower mean SBS values compared with those of the other three adhesives on different types of tooth structures and under different conditions (control and thermocycled) (p < 0.001). CONCLUSION: One-step self-etch adhesives containing ethanol as a solvent or co-solvent showed higher SBS compared with the other self-etching bonding agents. The bond strength values of these adhesives to dentin are significantly higher than those to enamel. CLINICAL RELEVANCE: The types of solvents of one-step self-etch adhesives had an effect on SBS, and the absence of solvent in those adhesives would adversely influence their performance. How to cite this article: Ageel FA, Alqahtani MQ. Effects of the Contents of Various Solvents in One-step Self-etch Adhesives on Shear Bond Strengths to Enamel and Dentin. J Contemp Dent Pract 2019;20(11):1260-1268.
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Recubrimiento Dental Adhesivo , Adhesivos , Cementos Dentales , Esmalte Dental , Dentina , Recubrimientos Dentinarios , Humanos , Ensayo de Materiales , Cementos de Resina , Resistencia al Corte , SolventesRESUMEN
OBJECTIVE: This study aimed to investigate the impact of tert-butylhydroquinone (TBHQ), chitosan, and their combination on memory and neurobiochemical parameters in a rat model. The primary objectives were to assess the cognitive effects of TBHQ, explore the cognitive-enhancing properties of chitosan, and evaluate the combined effects of these substances. MATERIALS AND METHODS: A rat model was employed for behavioral tests, biochemical analyses, and histological examinations. Rats were exposed to TBHQ, chitosan, or a combination of both, and cognitive function was assessed through behavioral tests. Biochemical analyses focused on neurobiochemical parameters associated with memory and oxidative stress. Histological examinations were conducted to observe any structural changes in the brain. RESULTS: TBHQ exposure was associated with memory impairments and increased oxidative stress, indicating potential neurotoxic effects. Chitosan supplementation demonstrated cognitive-enhancing effects and showed promise in mitigating the memory impairments and oxidative stress induced by TBHQ. The combination of chitosan and TBHQ presented a potential protective effect on neurological health. CONCLUSIONS: Chitosan supplementation alongside TBHQ may mitigate memory impairments and oxidative stress associated with TBHQ exposure in a rat model. The study provides valuable insights into the cognitive effects of TBHQ and the neuroprotective potential of chitosan, highlighting the need for further research to elucidate molecular pathways and clinical implications. These findings contribute to understanding chitosan's role in safeguarding neurological health in conditions where TBHQ exposure is a concern, warranting further investigations for translational applications in human health.
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Quitosano , Disfunción Cognitiva , Modelos Animales de Enfermedad , Hidroquinonas , Estrés Oxidativo , Animales , Hidroquinonas/farmacología , Hidroquinonas/administración & dosificación , Quitosano/farmacología , Quitosano/química , Disfunción Cognitiva/inducido químicamente , Disfunción Cognitiva/tratamiento farmacológico , Disfunción Cognitiva/prevención & control , Ratas , Estrés Oxidativo/efectos de los fármacos , Masculino , Fármacos Neuroprotectores/farmacología , Fármacos Neuroprotectores/administración & dosificación , Ratas Sprague-DawleyRESUMEN
Correction to: European Review for Medical and Pharmacological Sciences 2022; 26 (22): 8713-8718. DOI: 10.26355/eurrev_202212_30543- PMID: 36524490-published online on December 15, 2022. After publication, the authors applied a correction to the funding statement: The authors extend their appreciation to the deputyship for Research & Innovation, Ministry of Education in Saudi Arabia for funding this research work through the project number (lFP-2020-36). There are amendments to this paper. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/30543.
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OBJECTIVE: Cell phones are carried by 79% of people between 18 and 44 years of age for nearly the entire day. Smartphone users spend an average of three hours/per day on their devices, whereas heavy smartphone users spend 8-10 hours/per day on their devices. Text neck is a dangerous disorder that can accelerate the degeneration of the spine. This study aimed to investigate the efficacy of neck stabilization training vs. Contrology or Pilates training in individuals with Text Neck Syndrome. PATIENTS AND METHODS: Participants (n=75) with a history of recurrent neck pain in the previous four months, having moderate pain (at least 4/10 on the numeric pain rating scale, NPRS), and constantly using mobile phones (>4 hours/day) were randomly allocated to one of three groups: a control group (neck isometric training) and two intervention groups (neck stabilization training and Contrology). They were assessed for craniovertebral angle (CVA), NPRS, and neck disability index (NDI) at baseline and at 4 weeks post-intervention. RESULTS: There was a significant difference in the CVA, NPRS, and NDI among individuals with Text Neck Syndrome following intervention as compared to the control. Both the neck stabilization and Contrology training increased CVA and reduced neck pain and neck disability in individuals with Text Neck Syndrome. The two intervention groups showed similar effects in all the clinical outcome measures, suggesting almost equivalent effectiveness in the individuals with Text Neck Syndrome. CONCLUSIONS: Neck stabilization seems to work better than Contrology training when it comes to increasing the craniovertebral angle, reducing pain intensity, and making it easier for individuals with Text Neck Syndrome to move their necks.
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Teléfono Celular , Dolor de Cuello , Humanos , Dolor de Cuello/terapia , Cuello , Teléfono Inteligente , Columna VertebralRESUMEN
OBJECTIVE: The ensuing ischemia due to the disruption of blood supply to the brain is one of the most common causes of stroke. Evidence suggests a clear association of the ischemic injury with vascular dementia and Alzheimer's disease (AD). In response to the brain ischemia, a cascade reaction starts leading to neuronal damage due to oxidative stress and other inflammatory mediators. A pilot study was done, which showed that following stroke, monomeric-C-reactive protein (mCRP) is expressed in large quantities around the infarcted zone and this CRP is able to induce neurodegeneration and inflammation potentially perpetuating dementia. MATERIALS AND METHODS: We examined both patient brain samples and excised mouse brain tissue, previously injected with 1.75 mg/mL mCRP into the CA1 area of the hippocampus through the stereotactic surgical procedures and followed them over a period of over 6 months. The distribution of mCRP was examined through immunohistochemistry (mouse anti-human mCRP-specific antibodies 8C10). RESULTS: We observed a novel finding: those micro vessels close to the injection location were strongly stained with mCRP only in the mice that had been injected with mCRP, indicating that this small blood vessel can spread it throughout the brain. CONCLUSIONS: mCRP found in the brain after a hemorrhagic stroke promotes damage over a large area via the induction of inflammation and degeneration of perivascular compartments.
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Enfermedad de Alzheimer , Accidente Cerebrovascular , Animales , Ratones , Proteína C-Reactiva/metabolismo , Proyectos Piloto , Inflamación , Neuronas/metabolismo , Enfermedad de Alzheimer/metabolismoRESUMEN
Saudi Genome program is a revolutionary nationwide transformation initiative of Saudi Vision 2030. The program goals are to recognize and reduce the incidence of genetic diseases in the Kingdom of Saudi Arabia (KSA). Accordingly, the program will establish the foundation for personalized and genomic medicine in the KSA. Epilepsy has a high prevalence in KSA reaching around 6.54 of 1000 individuals with a subsequent massive financial burden. One of the main risk factors for this high prevalence and associated with increased risk of epilepsy development is consanguinity marriage, which is traditional in KSA. In this review, we executed a comprehensive state-of-art literature review regarding epilepsy genetics to offer a perception into the genes associated with epilepsy recognized in Saudi epileptic patients. Several genes' mutations were incorporated in this review including AFG3L2, ASPM, ATN1, ATP1A2, BMP5, CCDC88A, C12orf57, DNAJA1, EML1, ERLIN2, FRRS1L, GABRG3, NRXN3, MDH1, KCNJ10, KCNMA1, KCNT1, KIAA0226, OPHN1, PCCA, PCCB, PEX, PGAP2, PI4K2A, PODXL, PRICKLE1, PNKP, RELN, SCN2A, SCN1B, SLC2A1, SLC19A3, SLC25, SIAH1, SYNJ1, SZT2, TBCK, TMX2, TSC1, TSC2, TSEN, WDR45B, WWOX, UBR, UGDH, and YIF1B. For each of these genes, we tried to explain a little about the gene associated proteins and their roles in epilepsy development.
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Epilepsia , Proteasas ATP-Dependientes/genética , ATPasas Asociadas con Actividades Celulares Diversas/genética , Enzimas Reparadoras del ADN/genética , Epilepsia/genética , Humanos , Proteínas de la Membrana/genética , Proteínas de Transporte de Membrana/genética , Mutación , Proteínas del Tejido Nervioso/genética , Fosfotransferasas (Aceptor de Grupo Alcohol)/genética , Canales de potasio activados por Sodio , Proteínas Serina-Treonina Quinasas , Arabia SauditaRESUMEN
INTRODUCTION: The COVID-19 pandemic has obstructed the classical practices of psychological assessment and intervention via face-to-face interaction. Patients and all health professionals have been forced to isolate and become innovative to continue receiving and providing exceptional healthcare services while minimizing the risk of exposure to, or transmission of, COVID-19. AIM: This document is proposed initially as a guide to the extraordinary implementation of telepsychology in the context of the COVID-19 pandemic and to extend its implementation to use fundamentally as the main guideline for telepsychology services in Saudi Arabia and other Arabic communities. METHOD: A professional task force representing different areas of professional psychology reviewed, summarized, and documented methods, policies, procedures, and other resources to ensure that the recommendations and evidence reviews were valid and consistent with best practices. RESULTS: The practice of telepsychology involves the consideration of legal and professional requirements. This paper provides a guideline and recommendations for procedural changes that are necessary to address psychological services as we transition to telepsychology, as well as elucidates and demonstrates practical telepsychology frameworks, procedures, and proper recommendations for the provision of services during COVID-19. It adds a focused examination and discussion related to factors that could influence the telemedicine guideline, such as culture, religion, legal matters, and how clinical psychologists could expand their telepsychology practice during COVID-19 and after, seeking to produce broadly applicable guidelines for the practice of telepsychology. Professional steps in practical telemedicine were illustrated in tables and examples. CONCLUSION: Telepsychology is not a luxury or a temporary response. Rather, it should be considered part of a proactive governance model to secure a continuity of mental health care services. Arabic communities could benefit from this guideline to telepsychology as an essential protocol for providing mental health services during and after the COVID-19 pandemic.
INTRODUCTION: La pandémie COVID-19 fait obstacle aux pratiques classiques d'évaluation et d'intervention psychologiques par le biais d'une interaction en face à face. Les patients et tous les professionnels de la santé ont été contraints de s'isoler et d'innover pour continuer à recevoir et à fournir des services de santé exceptionnels tout en minimisant le risque d'exposition à la COVID-19 ou de transmission de cette maladie. OBJECTIF: Ce document se propose dans un premier temps comme un guide pour la mise en Åuvre extraordinaire de la télépsychologie dans le contexte de la pandémie COVID-19 et ensuite pour étendre sa mise en Åuvre afin de l'utiliser comme principale ligne directrice pour les services de télépsychologie en Arabie Saoudite et dans d'autres communautés arabes. MÉTHODE: Un groupe de travail professionnel représentant différents domaines de la psychologie professionnelle a examiné, résumé et documenté les méthodes, politiques, procédures et autres ressources afin de s'assurer que les recommandations et les examens des preuves étaient valides et conformes aux meilleures pratiques. RÉSULTATS: La pratique de la télépsychologie implique la prise en compte des exigences légales et professionnelles. Ce document fournit une ligne directrice et des recommandations pour les changements de procédure qui sont nécessaires pour traiter les services psychologiques lors de la transition vers la télépsychologie, ainsi qu'il élucide et démontre les cadres pratiques de la télépsychologie, les procédures et les recommandations appropriées pour la fourniture de services pendant la COVID-19. Il ajoute un examen et une discussion ciblés liés aux facteurs qui pourraient influencer la directive sur la télémédecine, tels que la culture, la religion, les questions juridiques, et la façon dont les psychologues cliniques pourraient étendre leur pratique de la télépsychologie pendant COVID-19 et après, en cherchant à produire des directives largement applicables pour la pratique de la télépsychologie. Les étapes professionnelles de la télémédecine pratique ont été illustrées dans des tableaux et des exemples. CONCLUSION: La télépsychologie n'est pas un luxe ni une réponse temporaire. Elle doit plutôt être considérée comme faisant partie d'un modèle de gouvernance proactive visant à assurer la continuité des services de soins de santé mentale. Les communautés arabes pourraient tirer profit de cette directive sur la télépsychologie en tant que protocole essentiel pour la fourniture de services de santé mentale pendant et après la pandémie COVID-19.
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BACKGROUND: Gram-negative organisms harbouring carbapenem resistance genes (CRGs) are spreading globally, including in Gulf Cooperation Council (GCC) countries. However, relatively few data are available about carriage of CRGs in hospitalized patients in this region. AIM: To determine prevalence of CRG carriage and risk factors for colonization among patients in GCC hospitals. METHODS: Rectal swabs were obtained from â¼50 intensive care unit (ICU) patients from each of 11 hospitals in five GCC countries between March and November 2019. The swabs were tested for the presence of blaKPC, blaNDM, blaVIM, blaIMP, and blaOXA-48 CRG using a commercial polymerase chain reaction test. Data on risk factors for colonization were collected and analysed. FINDINGS: Of 529 specimens screened, 138 (26.1%) were positive for one or more CRGs. The positivity rates among the hospitals ranged from 8.0% to 67.3%; â¼20% of the positive specimens harboured ≥2 CRGs. The most common CRG detected was blaOXA-48, which was present in 82 specimens (15.5%). Additional CRGs included blaNDM, blaVIM, blaKPC, and blaIMP either alone or in combination. Overall, 31.1% of patients on antibiotics on admission to the ICU were positive for CRGs compared to 16.5% not on antibiotic therapy (P < 0.001). CRG detection was also more common among patients aged >65 years (P = 0.027) and increased with hospital length of stay (P = 0.025). CONCLUSION: The rate of CRGs detected in hospitalized patients in GCC countries varied considerably. Prior antibiotic exposure, increasing age, and prolonged length of stay were associated with CRG detection.
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Proteínas Bacterianas , beta-Lactamasas , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Proteínas Bacterianas/genética , Carbapenémicos/farmacología , Hospitales , Humanos , Pruebas de Sensibilidad Microbiana , beta-Lactamasas/genéticaRESUMEN
Recent studies show that multidrug-resistant Streptococcus pneumoniae serotype 19A continues to emerge as a cause of invasive pneumococcal disease after the introduction of Prevnar. We report a case of multidrug-resistant S. pneumoniae serotype 19A meningitis successfully treated with vancomycin and levofloxacin. This case reinforces the need for the empiric use of vancomycin in meningitis and the need for alternative treatments.
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Meningitis Neumocócica/tratamiento farmacológico , Antibacterianos/uso terapéutico , Cefuroxima/uso terapéutico , Farmacorresistencia Bacteriana Múltiple , Quimioterapia Combinada , Humanos , Lactante , Levofloxacino , Meningitis Neumocócica/diagnóstico , Pruebas de Sensibilidad Microbiana , Ofloxacino/uso terapéutico , Streptococcus pneumoniae , Vancomicina/uso terapéuticoRESUMEN
BACKGROUND: Insomnia is a common problem that affects approximately 50% of patients with multiple sclerosis (MS), who suffer from sleep disturbances. In general, persons with insomnia are at a higher risk of developing depression. This study was conducted to assess insomnia among non-depressed MS patients in Saudi Arabia. METHODS: Based on the Patient Health Questionnaire-9 (PHQ-9), those who scored 4 or less for depression out of 598 MS patients were selected (n = 112). A cross-sectional study was conducted to interview 112 non-depressed MS patients in order to assess insomnia among them. A data collection sheet has been designed by the researchers. It comprised socio-demographic variables (e.g., gender, age, area of residence, and marital status) and clinical variables (disease duration, age at disease onset, previous diagnosis of depression, and used antidepressant drugs). Insomnia was assessed by the Insomnia Severity Index (ISI), while severity of illness was assessed using the Patient Determined Disease Steps (PDDS). RESULTS: A total of 72 patients (64.3%) were females, and 62 (55.4%) were married. Their mean age was 32.6 years (SD = 8.9), ranging from 15 to 56 years. As for educational level, 64 (57.1%) had a Bachelor degree. The mean age at disease onset was 26 years (SD = 8.9). The mean duration of illness was 1.9 years. Symptoms of insomnia were present among 14 patients (12.5%). No statistical significance was found between the mean PDSS of insomnia and non-insomnia patients. Significant differences were present between insomnia and non-insomnia patients as regards their education level (P = 0.005) and use of antidepressant drugs (P = 0.008). CONCLUSIONS: Prevalence of insomnia among non-depressed MS patients is low. Insomnia is associated with educational and use of antidepressants. Further research is needed to assess severity of different types of insomnia among depressed and non-depressed MS patients.
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OBJECTIVE: To evaluate the effects of different mold materials, their diameters, and light-curing units on the mechanical properties of three resin-based composites (RBC). METHODS AND MATERIALS: A conventional nano-filled resin composite (Filtek Supreme Ultra, 3M Oral Care, St Paul, MN, USA) and two bulk-fill composites materials, Tetric Evoceram Bulk fill (Ivoclar Vivadent, Schaan, Liechtenstein) and Aura Bulk Fill (SDI, Bayswater, VIC, Australia), were tested. A total of 240 specimens were fabricated using metal or white semitransparent Delrin molds that were 4 or 10 mm in diameter. The RBCs were light cured for 40 seconds on the high-power setting of either a monowave (DeepCure-S, 3M Oral Care) or polywave (Bluephase G2, Ivoclar Vivadent) light-emitting diode (LED) curing unit. The depth of cure was determined using a scraping test, according to the 2009 ISO 4049 test method. Data were analyzed using multivariate analysis of variance followed by Tukey multiple comparison test ( p<0.05). RESULTS: In general, when used for 40 seconds, both LED curing lights achieved the same depth of cure ( p=0.157). However, the mold material and its diameter had a significant effect on the depth of cure of all three RBCs ( p<0.0001). CONCLUSION: Curing with either the polywave or monowave LED curing light resulted in the same depth of cure in the composites. The greatest depth of cure was always achieved using the 10-mm-diameter Delrin mold. Of the three RBCs tested, both Tetric Bulk Fill and Aura achieved a 4-mm depth of cure when tested in the 10-mm-diameter metal mold. Tetric Bulk Fill was the most transparent and had the greatest depth of cure, and the conventional composite had the least depth of cure. Very little violet (<420 nm) light penetrated through 6 mm of any of the RBCs.
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Resinas Compuestas/uso terapéutico , Curación por Luz de Adhesivos Dentales , Luces de Curación Dental , Restauración Dental Permanente/métodos , Dureza , Humanos , Técnicas In VitroRESUMEN
The Hybrid Compact Gamma Camera (HCGC) is a small field of view (SFOV) portable hybrid gamma-optical camera intended for small organ imaging at the patient bedside. In this study, a thyroid phantom was used to determine the suitability of the HCGC for clinical thyroid imaging through comparison with large field of view (LFOV) system performance. A direct comparison with LFOV contrast performance showed that the lower sensitivity of the HCGC had a detrimental effect on image quality. Despite this, the contrast of HCGC images exceeded those of the LFOV cameras for some image features particularly when a high-resolution pinhole collimator was used. A clinical simulation showed that thyroid morphology was visible in a 5 min integrated image acquisition with an expected dependency on the activity within the thyroid. The first clinical use of the HCGC for imaging thyroid uptake of (123)I is also presented. Measurements indicate that the HCGC has promising utility in thyroid imaging, particularly as its small size allows it to be brought into closer proximity with a patient. Future development of the energy response of the HCGC is expected to further improve image detectability.
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Cámaras gamma , Cintigrafía/métodos , Glándula Tiroides/diagnóstico por imagen , Medios de Contraste/química , Diagnóstico por Imagen , Diseño de Equipo , Humanos , Procesamiento de Imagen Asistido por Computador , Radioisótopos de Yodo , Fantasmas de Imagen , Reproducibilidad de los Resultados , Tecnecio/químicaRESUMEN
OBJECTIVE: The aim of this study was to assess the bactericidal efficacy of antimicrobial photodynamic dynamic therapy (aPDT) as an adjunct to scaling and root planing (SRP) against periodontal pathogens. BACKGROUND DATA: SRP followed by laser therapy has better clinical outcomes than conventional SRP alone. MATERIALS AND METHODS: The question addressed was "Does aPDT as an adjunct to SRP exhibit better bactericidal effect against periodontal pathogens than the use of SRP alone in periodontal disease?" MEDLINE(®)/PubMed, Embase, Scopus, Web of Science, and Google Scholar databases were searched from 1977 to December 2015, using different combinations of key words. Review articles, in vitro and experimental studies, and articles in languages other than English were excluded. RESULTS: Seventeen clinical studies were included. Laser wavelengths and duration of irradiation ranged between 470 and 810 nm and 60 and 300 sec, respectively. All studies showed that aPDT application was effective in reducing the counts of periodontal microbes at follow-up. Four studies showed significantly reduced bacterial counts for aPDT as an adjunct to SRP compared with SRP alone. Thirteen studies showed comparable reduction in the counts of periodontal bacteria when aPDT alone or as an adjunct to SRP was compared with SRP alone. CONCLUSIONS: The bactericidal efficacy of aPDT as an adjunct to SRP against periodontal pathogens in periodontal disease remains debatable.
Asunto(s)
Antibacterianos/administración & dosificación , Enfermedades Periodontales/microbiología , Enfermedades Periodontales/terapia , Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes/administración & dosificación , Antibacterianos/uso terapéutico , Raspado Dental , Humanos , Enfermedades Periodontales/tratamiento farmacológico , Fármacos Fotosensibilizantes/uso terapéutico , Aplanamiento de la RaízRESUMEN
Recently, "budget" dental light-emitting diode (LED)-based light-curing units (LCUs) have become available over the Internet. These LCUs claim equal features and performance compared to LCUs from major manufacturers, but at a lower cost. This study examined radiant power, spectral emission, beam irradiance profiles, effective emission ratios, and the ability of LCUs to provide sustained output values during the lifetime of a single, fully charged battery. Three examples of each budget LCU were purchased over the Internet (KY-L029A and KY-L036A, Foshan Keyuan Medical Equipment Co, and the Woodpecker LED.B, Guilin Woodpecker Medical Instrument Co). Major dental manufacturers provided three models: Elipar S10 and Paradigm (3M ESPE) and the Bluephase G2 (Ivoclar Vivadent). Radiant power emissions were measured using a laboratory-grade thermopile system, and the spectral emission was captured using a spectroradiometer system. Irradiance profiles at the tip end were measured using a modified laser beam profiler, and the proportion of optical tip area that delivered in excess of 400 mW/cm(2) (termed the effective emission ratio) was displayed using calibrated beam profile images. Emitted power was monitored over sequential exposures from each LCU starting at a fully charged battery state. The results indicated that there was less than a 100-mW/cm(2) difference between manufacturer-stated average tip end irradiance and the measured output. All the budget lights had smaller optical tip areas, and two demonstrated lower effective emission ratios than did the units from the major manufacturers. The budget lights showed discontinuous values of irradiance over their tip ends. One unit delivered extremely high output levels near the center of the light tip. Two of the budget lights were unable to maintain sustained and stable light output as the battery charge decreased with use, whereas those lights from the major manufacturers all provided a sustained light output for at least 100 exposures as well as visual and audible indications that the units required recharging.